International Meeting for Autism Research (London, May 15-17, 2008): USING "SCALABLE" MODELS TO IMPROVE ACCESS TO AUTISM SERVICES: SUCCESSES AND CHALLENGES

USING "SCALABLE" MODELS TO IMPROVE ACCESS TO AUTISM SERVICES: SUCCESSES AND CHALLENGES

Saturday, May 17, 2008
Champagne Terrace/Bordeaux (Novotel London West)
11:30 AM
D. S. Murray , Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital /University of Cincinnati, Cincinnati, OH
P. Manning-Courtney , Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital/University of Cincinnati, Cincinnati, OH
C. Luzader , Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Background:   Autism diagnostic and treatment providers are under increasing pressure to provide effective and timely services to a rapidly growing number of children with ASD. Intervention models are largely unchanged, despite the dramatic increase in demand. Without significant systems change, providers will not be able to meet the growing demand for services. 
Objectives:   Improve access to autism treatment at a hospital-based, multidisciplinary diagnostic and treatment program using health improvement science.
Methods: Numbers of children undergoing treatment at The Kelly O’Leary Center for Autism Spectrum Disorders (TKOC) were tracked monthly, with a goal of increasing the total number of children accessing treatment services at TKOC by 25% per year utilizing the same FTE staffing.  Treatment programs were re-designed to be more “scalable,” thus allowing for increased access to children not previously able to receive treatment. 
Results:   Numbers of children who accessed treatment services at TKOC increased from 178 to 483 for the period from June 2005-Dec 2007. In addition, by applying the concept of scalable models to medical treatment,  we were able to add an additional 700 medical follow up visits per year. Secondary benefits included a reduction in no show/cancellation rates (15% Dec 07 from 23% June 05). Additional benefits and challenges will be discussed.
Conclusions:   Access to treatment services can be improved through health improvement science techniques.  The on-going process improvement work at TKOC continues to provide important learnings to educate providers to more effectively implement “scalable” intervention models. The increased need for autism treatment programs not only demands research in outcomes of scalable models, but also demands more extensive research in health improvement sciences to investigate the system changes necessary to allow more children with ASD to access much needed services.
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